Changes in the diet may be helpful but are usually not effective alone. A recent study comparing a liquid yogurt fiber mixture to lactulose in 147 children revealed comparable results in the treatment of constipation (Kokke, Scholtens, Alles, et al, 2008). Encounraging the intake of fiber ultimately helps maintain regular elimination once the rectum returns to normal size and the laxatives are tapered. Effective counseling is an essential element of the treatment plan for children with chronic constipation. Explain normal bowel function, the purpose of interventions, and the need for persistence to the child and family.